Treatment Costs and Patterns In Patients With Multiple Sclerosis Treated With Prolonged-Release Fampridine In Germany

To examine the treatment patterns and direct medical costs of patients with multiple sclerosis (MS) treated with prolonged-release (PR) fampridine tablets (dalfampridine extended-release in the US) 12 months pre- and post-initiation of treatment. A retrospective analysis of the Health Risk Institute research database, which contains healthcare and prescription claims of approximately 80 German health insurances, was conducted. Patients with MS who initiated treatment with PR-fampridine (index date) were identified between January 1, 2011 and December 31, 2012. Eligible patients were required to be continuously insured during 12 months pre- and post-index date and to have at least one PR-fampridine prescription in the 4th quarter after the index date. Pre- vs. post-index costs and utilization of inpatient stays were compared related to MS and prescription medications using each patient as their own control. A total of 478 patients were eligible and included in this analysis. The mean (SD) age was 50.1 (9.5) years, 54.0% of patients had no concomitant disease modifying therapy and 64.9% were female at baseline. A significant decline (all p<0.001) in the mean (SD) number of MS-related inpatient stays -0.20 (1.06); mean (SD) total length of stay -1.02 (8.84); and proportion of patients with an inpatient stay pre-index vs. post-index period (31.4% vs. 23.6%) was observed. A significant (p<0.001) decrease in mean (SD) inpatient costs for the pre- vs. post-index periods was also observed: €1,718 (3,406) vs. €1,305 (3,844), respectively, or €-413 (3,211). An increase in the costs of MS-related prescription medications in the post-period was attributed to the cost of PR-fampridine. Treatment with PR-fampridine resulted in a reduction of inpatient hospital stays, number of days, and MS-related costs within one year in German MS patients. Further research is needed to understand how improvement in walking may reduce direct MS-related outpatient utilization and costs.